Article excerpt

PROFESSOR KAROL SIKORA, one of our top cancer doctors, with his verdicton the NHS relaunch

EVERY healthcare system throughout the world is currently in the middle of aperfect storm.

The deepening crisis engulfing all health services has been caused by threecrucial factors: ageing populations, mounting costs in advancing technology andtreatment, and wellinformed service users who are used to making sophisticatedconsumer choices.

Yet the problems are perhaps more acute in Britain than anywhere else inWestern Europe, not least because our monolithic National Health Service isproving too inflexible, bureaucratic and outdated to meet the challenges of thenew era.

Sixty years old this month, the NHS was designed for an entirely different age,when life expectancy was far lower, medicine was less complex and the Britishpopulation, having emerged from six years of gruesome war, was much moresubservient to state authority.

The Labour Government, while adopting an increasingly proprietorial air towardsthe NHS in the run-up to the 60th anniversary, has recognised the system is indire need of reform.

Bureaucracy The strategy adopted during the years of Tony Blair's rule was tothrow vast mountains of cash at the system. Since Labour came to power, NHSspending has more than trebled, topping [pounds sterling]100 billion annually.

But real change was not delivered, so the usual problems have persisted,particularly in the rationing of treatment, the differing standards throughoutthe country and the increasing costs of a top-heavy bureaucracy.

When Gordon Brown arrived in Downing Street last summer, he appointed a leadingand very capable surgeon, Lord Darzi, as one of his health ministers andordered him to conduct a fullscale review of the NHS.

The result is the document launched yesterday under the optimistic and slightlySovietsounding title High Quality Care For All.

But it would be wrong to be too cynical. Lord Darzi is a dedicated healthcareprofessional, not a calculating career politician, and there is much to admirein his document.

For a start, the idea of creating polyclinics in every town is an excellentone, vastly improving access to healthcare, especially for those who have busyworking lives and cannot easily get to GPs surgeries during the day.

These new-style polyclinics have been given a bad press by the doctors'professional union, the British Medical Association.

As a result of this negative campaign, they have been presented as adestructive alternative to the trusted GP.

Nothing could be further from the truth. Polyclinics are a complement tocurrent services and, if run properly, they will expand the range of thetreatments available, thereby reducing the pressure on hospitals and deliveringcare far closer to patient's homes.

Mind you, for all the benefits of polyclinics, it was this Government thatshattered the tradition of GPs providing 24- hour cover through itsdisastrously botched negotiations of the last GP contract, which alloweddoctors to reduce drastically their hours and yet receive more money.

In part, therefore, polyclinics are a solution to a problem created byministers.

There are other aspects of the Darzi report to be welcomed.

The proposed NHS constitution, which legally enshrines patients' rights, shouldact as a restraint on authorities trying to block certain types of treatment.

Lord Darzi's call for closer working between the various branches of the NHS iscommon sense, though too often ignored by empire-building bureaucrats whojealously guard their own territories.

Speeding up the procedures by which the National Institute of ClinicalExcellence (NICE)

decides whether to license a certain drug will also benefit thousands ofpatients. …